Individual
MR. ALEXANDER THOMAS KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
429 N COURTLAND ST, EAST STROUDSBURG, PA 18301-1906
(484) 225-4323
Mailing address
5 FIELDCREST DR, BUDD LAKE, NJ 07828-2221
(908) 723-1087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SL06438600
SOCIAL WORK LICENSE NUMBER
NJ
Enumeration date
11/05/2019
Last updated
11/05/2019
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